The ‘Oxford English Dictionary’ offers the following definition of shame, ‘painful distress or humiliation’, and mortification as ‘great embarrassment and shame’. In clinical work shame can be imagined as a continuum (i.e. the social and psychological dynamics of shame) that runs from mild forms of embarrassment (i.e. mostly under cortical influence, language and meaning-making) to greater and greater disability, towards humiliation and finally, to mortification, that is, the wish to die or disappear (Kilbourne, 2002; Lansky, 1997, 2007). And each of these may be accompanied by specific symptoms. As one moves along this continuum, cognition, behaviour and emotion are increasingly under the influence of subcortical and somatic responses.
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